The Challenges of Conducting Research in Rural Populations: A Feasibility Study

Purpose: Chronic stress related to health disparities results in negative health outcomes for mothers and infants. The brain-gut-immune axis plays a significant role in perinatal health outcomes. Researchers have not focused on the effects of rural living on the maternal/infant gut microbiome. The purpose of our study was to validate recruitment protocols, data and specimen collection protocols, participant feedback, and participant retention strategies for future studies in a rural Nebraska population of mother/infant dyads. Sample: Mother/infant dyads living in Nebraska counties with a rural-urban commuting area (RUCA) code of three or greater (n = 17 dyads, n = 1 triad). Methods: We conducted a cross-sectional pilot feasibility study by collecting stool samples, actigraph data, sleep diaries, and health and lifestyle questionnaires from mother/infant dyads living in rural Nebraska counties. Findings: Retrospective review of this pilot study identified the main feasibility findings were primarily related to distance: 1) relying on virtual recruiting methods was cost-effective; 2) stool sample shelf-life created participant inconvenience; 3) shipping carrier delays affected collection timing of actigraph data; 4) participant access to shipping carrier drop-offs increased cost and inconvenience. Conclusion: Rural locations create barriers to research, but none are insurmountable. When working with rural populations, it is important to consider the potential adaptation of participant recruitment methods and protocol procedures, including careful attention to shipping and related time constraints that may impact data collection.